Guide tube for a treating instrument to be inserted into body cavity

ABSTRACT

There is provided a guide tube for guiding a tubular treating instrument to be inserted into a patient&#39;&#39;s body cavity. Said guide tube includes a tubular, flexible main body. A cuff is attached to said main body in the proximity of the forward end thereof, and is so adapted as to be expanded by the operation of air or liquid feed from the base end portion of the main body. The main body is further extended forwardly from the cuffattached portion, and said extended portion is formed more flexible than the main body. The guide tube is fixed within the body cavity by the expansion of the cuff, and the treating instrument is inserted up to a predetermined position in the interior of the body cavity with the guide tube taken as a guide.

United States Patent Kawahara Oct. 21, 1975 [5 GUIDE TUBE FOR A TREATING 3,034,510 5/1962 Kittel 1223/3493 1 INSTRUMENT TO BE INSERTED INTO 3,470,876 10/1969 Barchilon 128/2 M X 3,670,721 6/1972 Fukami etal 128/6 BODY CAVITY 3,780,740 12/1973 Rhea 128/350 R Inventor: Ichizo Kawahara, Kokubunji, Japan Olympus Optical Co., Ltd., Tokyo, Japan Filed: Apr. 25, 1974 Appl No.: 464,141

Assignee:

Foreign Application Priority Data May 18, 1973 Japan 48-55224 US. Cl. 128/2 M; 128/8; 128/349 B; 128/351 Int. Cl. A6lM 25/00; A61B 1/26 Field of Search 128/2 M, 3-8, 128/343, 276, 348-357, DIG. 9

References Cited UNITED STATES PATENTS 2/1950 Mains 128/348 X s. 5 VIA 'lz illlIt I g I 4 Primary Examiner-Dalton L. Truluck 57 ABSTRACT There is provided a guide tube for guiding a tubular treating instrument to be inserted into a patients body cavity. Said guide tube includes a tubular, flexible main body. A cuff is attached to said main body in the proximity of .the forward end thereof, and is so 4,Claims, 8 Drawing Figures U.S. Patent Oct. 21, 1975 Sheet10f2 3,913,565

F I G. i F l G. 2

' PRIOR ART US. Patent Oct. 21, 1975 Sheet 2 of2 3,913,565

FIG.5

FIG.6

FIG.8

PRIOR ART GUIDE TUBE FOR A TREATING INSTRUMENT TO BE INSERTED INTO BODY CAVITY BACKGROUND OF THE INVENTION This invention relates to the construction of a guide tube for guiding up to a predetermined position of within the body cavity a tubular treating instrument to be inserted into the body cavity, such as an intestinal tube used to sample the intestinal juice or a Miller Abott tube used for the intestinal obstruction.

In the case of using an intestinal tube for sampling intestinal juice or a Miller Abott tube, it is generally required for these tubes to be inserted up to the interior of the ileum.

For example, as shown in FIG. 1, a tube 1 such as an intestinal tube can be relatively easily inserted without using guide means up to the interior of the stomach 2. However, the insertion of the forward end of the tube 1 into the pars pylorica 3 constitutingthe connecting section of the stomach 2 with the duodenum is accompanied with an extreme operational difficulty and therefore requires a higher level of technique and a longer time. Indeed, if the forward end of the tube 1 has only to be able to be inserted into the pars pylorica 3, it will be possible to feed the tube 1 into the ileum with the aid of the vermicular movement. But the insertion of the tube 1 into the pars pylorica, as above described, requires a higher level of technique and a longer time, and in some cases it is necesary to carry out the insertion while it is being observed by the X ray-radiation. Further, even if the vermicular movement is utilized and even if, for example, medicines are used to promote the vermicular movement, the utilization of the vermicular movement alone will require several hours for passing the forward end of the tube 1 through the pars pylon'ca. For this reason, the patient must endure a long restraint and pain until the tube insertion is completed. Particularly, in the case of a patient suffering from the intestinal obstruction, unless he is subjected to urgent treatment, another disease, for example, the peritonitis is accompanied, giving rise to a serious situation to him. i

The passage extending from the duodenal cap 4 immediately succeeding the pars pylorica 3 to the downward extending section 5 of the duodenum is in a sharply curved state and said curve does not take place on the same plane but in a three dimensional form. Usually, therefore, the tube 1 conflicts with the inner walls of the downward extending section 5 of the duodenum and thereby is interrupted from advancing. Furtherrnore, since the interior of the downward extending section 5 is relatively large, the direction in which the forward end of the tube 1 is advanced is not determined, so that the tube 1 becomes liable to conflict with the inner walls of said section 5 and therefore becomes difficult to advance. Even under these circumstances, the tube 1 was conventionally obliged to be subjected to the natural advancement by the vermicular movement to some extent, giving rise to the waste of a large length of time and a patients pain in inserting the tube up to the ileum.

SUMMARY OF THE INVENTION.

The general object of the invention is to provide a guide tube for a treating instrument which is designed to eliminate the difficulties accompanying the abovementioned operations in the case of inserting a tubular treating instrument into the body cavity.

The guide tube of the invention comprises an elongate, flexible main body which has an inner diameter enough to admit of the insertion of an endoscope, celoscope and body cavity-treating instrument, a cuff (or termed balloon) attached to said main body in the proximity of the forward end thereof and expanded by the operation of air or liquid feed from the base end portion of the main body, and a flexible tube section further extended forwardly from the cuff-attached portion and integrally with the forward end of the main body and formed more flexible than the main body.

Accordingly, a primary object of the invention is to provide a guide tube for permitting a body cavity treating instrument to be readily inserted for an extremely short time up to a predetermined position in the interior of the body cavity.

Another object of the invention is to provide a guide tube for a treating instrument capable of being made simple in construction and therefore manufactured inexpensively.

Other objects and advantages of the invention will become apparent from the hereinafter detailed descrip tion of the preferred embodiment of the invention for which reference is made to the appended drawings.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a view showing the prior art manner in which an intestinal tube is inserted into a body cavity;

FIG. 2 is a view showing the manner in which a celoscope is inserted into the body cavity;

FIG. 3 is a view showing the manner in which a guide tube according to the invention is inserted into the body cavity by utilizing the celoscope;

FIG. 4 is a partially broken side view of an embodiment of the guide tube according to the invention;

FIG. 5 is a partially broken side view of another embodiment of the guide tube according to the invention; and

FIGS. 6 to 8 are views respectively showing the manner in which the guide tube according to the invention is used.

DETAILED DESCRIPTION OF THE INVENTION In FIG. 4, an elongate guide tube 7 according to the invention is shown partly omitted. Said guide tube 7 has a tubular flexible main body 8, which is constituted by a flexible inner tube 10 and outer tube 11 made of, for example, synthetic resin and a helical winding 9 wound between the both tubes 10 and 11 around the outer periphery of the inner tube 10. Said helical winding 9 is formed of, for example, metal or tough plastic material, and functions as reinforcing means for reinforcing the main body 8 so as to prevent it from being buckled. Further, the inner tube 10 and outer tube 1 1 are further extended forwardly from the forward end portion 8a (the right side of FIG. 4) of the main body 8 at which the helical winding 9 is terminated, and the extended portions of the both tubes are mutually adhered to constitute a flexible section 12 formed more flexible than the main body 8. Although the main body 8 is elongate as above described, the presence of the helical winding 9 prevents the main body 8 from being deformed in diameter, by the reinforcing function thereof, thereby causing the main body 8 to maintain its cross section of a fixed shape, and in spite of this the main body is maintained flexible. As later described the flexible tube 14 of the celoscope or endoscope 13 and an intestinal tube 15 are inserted into the interior of the main body 8 of the guide tube, and the main body has an inner diameter large enough to facilitate said insertion.

On the outer periphery of'the forward end portion 8a of the main body 8 is attached an expansible and contractible bag-shaped member 16 termed cuff" or balloon (hereinafter referred to simply as cuff). In this embodiment, said cuff 16 is secured to the entire outer periphery of the outer tube 11 so as to surround the same, but may be provided partially on the outer periphery of the outer tube 1 1. The interior of the cuff 16 is designed to be supplied with air or liquid through an aperture 17 formed in the outer tube 11, and the cuff 16 is usually in a deformed or contracted state but is designed to be expanded upon the entry of air or liquid.

On the base end portion 8b (the left side of FIG. 4) of the main body 8 of the guide tube is mounted a metallic cap 18, which is formed at its center with a tube insertion hole 18a along the axis of the guide tube 7 and with a passage 19 for passing air or liquid therethrough. A mouth piece 20 is mounted on the metallic cap 18 at the openingend portion of said passage 19.

Said passage 19 extends to one end of the helical winding 9 and communicates with the interior of the cuff 16 through a helical space 21 formed in the helical winding 9, namely defined by the inner and outer tubes 10 and 11 with the helical winding 9 and then through the aperture 17. Accordingly, when air or liquid is introduced into the passage 19 from the mouth piece 20, the fluid is helically passed through the helical space 21 and introduced from the aperture 17 into the interior of the cuff 16 to cause the cuff 16 to be expanded.

In FIG. a guide tube according to another embodiment of the invention is shown.

Said guide tube has substantially similar construction to that shown in FIG. 4 excepting that the helical winding 9 constituting reinforcing means of the main body 8 of FIG. 4 is replaced with a net-like member 90 in FIG. 5. Said net-like member90 may be made of metal or synthetic resin. Namely said member 90 has only to be formedat least flexible. Said member 90 is disposed between the inner tube and the outer tube 11 as in the case of the reinforcement member of FIG. 4. The air or liquid introduced from the mouth piece into the passage 19 reaches the aperture 17 by passing through the meshes of the net-like member 90 and then enters the cuff 16 through said aperture 17.

Said net-like member 90 can be provided in various forms but has only to be flexible and formed with spaces for passing therethrough at least air or liquid from the passage 19 up to the aperture 17.

There will now be described the case where a guide tube, for example, a guide tube 7 shown in FIG. 4, having the above-mentioned construction is used.

Generally, it takes several minutes to thirty minutes at the longest to insert the flexible tube 14 of the celoscope or endoscope 13 up to the jejunum 22 from a patients mouth or nose as shown in FIG. 2 while observation is being made by said celoscope or endoscope. That is, the insertion is relatively easily carried out.

FIG. 2 shows the condition in which the flexible tube 14 of the celoscope or endoscope 13 is sufficiently inserted just up to the jejunum 22.

Prior to the insertion of the flexible tube 14 of the celoscope or endoscope 13, the. guide tube 7 according to the invention is beforehand fitted into said flexible tube 14 as shown in FIG. 3. When the flexible tube 14 has sufficiently been inserted into a patients body cavity, said guide tube 7 is inserted into the body cavity along said tube 14 with said tube 14 taken as a guide, and it is confirmed through observation by, for example, X-ray radiation that the portion of the guide tube 7 on which the cuff 16 is mounted has reached the duodenal cap 4. Thereafter, for example, air is introduced from the mouth piece 20 to expand the cuff 16. The mouth piece 20 is of course positioned outside the patients body. As shown in FIG. 6, the cuff 16 is pressed against the inner walls of the duodenal cap 4 due to its expansion, thereby causing the guide tube 7 to be fixed to its inserted position. After completion of the fluid-entering, the mouth piece 20 is properly sealed in order to maintain the cuff l6 expanded.

After completion of the guide tube 7 fixing, only the flexible tube 14 of the celoscope or endoscope 13 is drawn out externally of the patients body through the guide tube 7. g

Where the guide tube 7 is inserted into the body cavity, it can also be inserted thereinto together with the flexible tube 14 of the celoscope or endoscope 13 during the insertion of the same.

The guide tube 7 is set to a predetermined position of within the body cavity through said insertion operation. Under this condition, said flexible section 12 of the guide tube 7 is extended up to the downward extending section 5 of the duodenum. Accordingly, the

intestinal tube 15 can readily and quickly be inserted.

up to the jejunum 22 by being passed through the guide tube 7 with the guide tube 7 taken as a guide. Further, upon insertion of the tube 15, it is guided by the guide tube 7 so as to be prevented from being buckled, so that the insertion force applied to the tube 15 acts almost entirely on the direction in which the tube 15 is thrusted, and thereby is transmitted up to the forward end of the tube 15. Accordingly, the tube 15 is inserted readily, quickly into the body cavity simply by a weak insertion force.

In the prior art case of using no such guide tube 7, even after the forward end of the tube 1 has been able to be inserted into the interior of the duodenum, the tube advancing operation is obliged to be carried out by the vermicular movement. The reason is that, as

shown in, FIG. 8, even if attempts are made to perform the forceful insertion of the tube 1, the insertion force will be scattered in arrow-indicated directions only to cause the tube 1 to be coiled or loosened within the stomach 2 large in space, so that the insertion force is interrupted from being transmitted to the forward end of the tube 1. For the above-mentioned reasons, the priorart tube insertion operation performed without using the guide tube 7 was accompanied by a large length of time and difficulties until the tube insertion was completed.

By the use of the guide tube according to the invention a body cavity-treating instrument, having objects to be attained, such as the intestinal tube can beset to a predetermined position in the interior of the body cavity within several to 30 minutes at the longest. Ac-

cordingly, a patients pain is alleviated and simultaneously quick, efficient diagnostication activities can be expected.

The guide tube of the invention can be applied not only to the intestinal tube but also to various body cavity-treating instruments, and it is therefore apparent that the guide tube of the invention is not limited to the use referred to in the preceding embodiments.

What is claimed is:

1. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising:

a. a flexible tubular main body having a forward end and a base end at which the treating instrument is inserted into the main body, said main body including an inner tube, an outer tube having an aperture and a helical winding wound between the inner and outer tubes around the outer periphery of the inner tube;

. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be expanded by the entry thereinto of fluid from the base end of the main body first through a space defined by said helical winding with the inner and outer tubes and then through said aperture thereby to be pressed against inner walls of the body cavity to fix the forward end of the guide tube to the interior of the body cavity; and

c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity.

2. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising:

a. a flexible tubular main body having a forward end i from being buckled,

b. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be expanded by the entry thereinto of fluid from the base end of the main body first through the meshes of said net-like member and then through said aperture thereby to be pressed against inner walls of the body cavity to fix the forward end of the guide tube to the interior of the body cavity; and

c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity.

3. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising:

a. a flexible tubular main body having a forward end and a base end at which the treating instrument is inserted into the main body;

. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be exapnded by the entry thereinto of fluid from the base end of the main body, so as to be pressed against inner walls of the body cavity thereby to fix the forward end of the guide tube to the interior of the body cavity;

c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity; and

d. a metallic cap mounted on the base end of the main body and formed with a tube insertion hole for allowing a treating instrument to be inserted into the main body.

4. A guide tube for a body cavity-treating instrument as described in claim 3 wherein said metallic cap is formed with a passage for allowing fluid to be sent from outside into the interior of the cuff. 

1. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising: a. a flexible tubular main body having a forward end and a base end at which the treating instrument is inserted into the main body, said main body including an inner tube, an outer tube having an aperture and a helical winding wound between the inner and outer tubes around the outer periphery of the inner tube; b. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be expanded by the entry thereinto of fluid from the base end of the main body first through a space defined by said helical winding with the inner and outer tubes and then through said aperture thereby to be pressed against inner walls of the body cavity to fix the forward end of the guide tube to the interior oF the body cavity; and c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity.
 2. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising: a. a flexible tubular main body having a forward end and a base end at which the treating instrument is inserted into the main body, said main body including an inner tube, an outer tube having an aperture and a net-like member wound between the inner and outer tubes around the outer periphery of the inner tube for preventing said inner and outer tubes from being buckled, b. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be expanded by the entry thereinto of fluid from the base end of the main body first through the meshes of said net-like member and then through said aperture thereby to be pressed against inner walls of the body cavity to fix the forward end of the guide tube to the interior of the body cavity; and c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity.
 3. A guide tube for guiding a body cavity-treating instrument up to a predetermined position in a body cavity comprising: a. a flexible tubular main body having a forward end and a base end at which the treating instrument is inserted into the main body; b. a cuff mounted on said main body in the proximity of the forward end thereof and adapted to be exapnded by the entry thereinto of fluid from the base end of the main body, so as to be pressed against inner walls of the body cavity thereby to fix the forward end of the guide tube to the interior of the body cavity; c. a flexible tube section further extended forwardly from the forward end of the main body and formed more flexible than the main body, whereby the forward end of the treating instrument inserted from the base end into the main body is sent forth from said flexible tube section and carried up to the predetermined position in the body cavity; and d. a metallic cap mounted on the base end of the main body and formed with a tube insertion hole for allowing a treating instrument to be inserted into the main body.
 4. A guide tube for a body cavity-treating instrument as described in claim 3 wherein said metallic cap is formed with a passage for allowing fluid to be sent from outside into the interior of the cuff. 